Outreach Care Specialist

Location: Virtual. This role enables associates to work virtually full-time, with the exception of required in-person training sessions, providing maximum flexibility and autonomy. Candidates must be within a reasonable commuting distance from the posting location(s) unless an accommodation is granted as required by law.

About the role

The Outreach Care Specialist is responsible for ensuring that appropriate member treatment plans are followed on less complex cases and for proactively identifying ways to improve the health of our members and meet quality goals.

Responsibilities

• Coordinates follow-up care plan needs for members by scheduling appointments or enrolling members in programs.
• Assesses member compliance with medical treatment plans via telephone or through on-site visits.
• Identifies barriers to plan compliance and coordinates resolutions.
• Identifies opportunities that impact quality goals and recommends process improvements.
• Recommends treatment plan modifications and determines need for additional services, in conjunction with case management and provider.
• Coordinates identification of and referral to local, state or federally funded programs.
• Coaches members on ways to reduce health risks.
• Prepares reports to document case and compliance updates.
• Establishes and maintains relationships with agencies identified in appropriate contract.

Requirements

• H.S. diploma or equivalent and a minimum of 1 year related experience; or any combination of education and experience which would provide an equivalent background.

Preferred Qualifications

• Pharmacy/Infusion background.
• Certified nurse assistant or certified medical assistant and/or BS/BA degree in a related field.
• Bilingual candidates.
• Experience keeping schedule of home infusion patients.
• Knowledge of Microsoft Office products (Excel, SharePoint, Word, etc).
• Knowledge of Adobe and Smartsheet.
• Knowledge of CareTend.
• Understanding of Home Health contracting.
• Experience with WFH environment.
• Excellence in self-management of time and organizational skills.

For URAC accredited areas, associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills. For Carelon - CareBridge business unit, bilingual or multi-language skills may be required.

Pay

The salary range for this specific position is $18.46/hr to $33.50/hr for candidates in Washington, Colorado, Minnesota, and Nevada. The salary offered is based on geographic location, work experience, education, and skill level.

Benefits

In addition to salary, Elevance Health offers a comprehensive benefits package, incentive and recognition programs, equity stock purchase, and 401k contribution (all benefits are subject to eligibility requirements). Benefits include:

• Merit increases, paid holidays, and Paid Time Off.
• Incentive bonus programs (unless covered by a collective bargaining agreement).
• Medical, dental, vision, short and long-term disability benefits.
• 401(k) with company match.
• Stock purchase plan.
• Life insurance.
• Wellness programs and financial education resources.

Schedule

Elevance Health operates in a Hybrid Workforce Strategy. Associates are required to work at an Elevance Health location at least once per week, and potentially several times per week, unless specified as primarily virtual by the hiring manager.